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Resume Propos Description clinique de patients presentant un lymphome associe a des manifestations renales. Methodes Nous avons identifie les cas de lymphomes accompagnes de manifestations renales, avec documentation histologique renale, pris en charge sur le CHU de Bordeaux entre 1996 et 2004. Resultats Nous rapportons une serie de quatre observations. Il s'agit de quatre patients ayant presente un lymphome non hodgkinien B. L'atteinte renale s'est manifestee initialement par un syndrome nephrotique chez deux patients et par une atteinte tumorale renale dans deux cas. L'histologie renale a permis le diagnostic de lymphome chez trois patients. Conclusion L'atteinte renale au cours des lymphomes peut correspondre a une atteinte directe par la proliferation maligne ou aux consequences immunologiques du processus lymphomateux. Certaines formes histologiques particulieres telles que le lymphome intravasculaire et le lymphome primitif renal sont a l'origine de difficultes diagnostiques.

A 58-year-old man presented with fever and a rapidly progressive glomerulonephritis. An infective endocarditis due to Streptococcus parasanguis was diagnosed. A renal biopsy revealed type III pauci-immune crescentic glomerulonephritis. As first-line therapy, antibiotics were administered alone. Faced to the unsuccessful anti-infective approach, corticosteroid therapy was added as a second-line therapy. Finally, plasmapheresis introduced as the third-line therapy, significantly improved renal function. This case is an original type III rapidly progressive glomerulonephritis, since ANCA were repeatedly found negative. In very few cases, plasmapheresis was successfully used for the treatment of infective endocarditis-induced crescentic glomerulonephritis. The pathophysiology and the potential efficiency of plasmapheresis are discussed.

Resume Introduction La survenue de tumeurs plasmocytaires chez les patients de moins de 40 ans etait rare avant l'infection a VIH. Moins frequentes que le lymphome, il existe cependant une augmentation d'incidence de ces maladies chez les patients seropositifs. Sur ce terrain, outre l'âge de survenue plus jeune, la presentation clinique est differente avec une grande frequence de plasmocytomes extramedullaires dont les localisations peuvent etre surprenantes. Ex'egese Nous rapportons ainsi le cas d'une patiente de 29 ans infectee par le VIH chez laquelle ont ete diagnostique des plasmocytomes occipitaux, parotidiens, sphenoidaux, epiduraux et uterins pour lesquels un traitement par chimiotherapie (trois cures de VAD) et une radiotherapie epidurale ont permis d'obtenir une bonne reponse. L'augmentation de l'incidence des tumeurs plasmocytaires chez les patients infectes par le VIH pourrait etre favorisee par la coinfection par le virus d'Epstein-Barr, la stimulation antigenique chronique due au VIH, la secretion d'interleukine 6 par les lymphocytes infectes. Conclusion Les tumeurs plasmocytaires font partie de la liste des neoplasies dont l'incidence est favorisee par le VIH; leur pronostic actuellement mediocre devrait s'ameliorer grâce a l'apport des traitements antiretroviraux hautement actifs autorisant une intensification chimiotherapique avec eventuelle autogreffe.

An unusual case of acinic cell tumour of the vallecula is presented. Acinic cell carcinoma occurs usually in the major salivary glands. Minor salivary gland location is unusual and vallecular origin exceptional. This peculiar histologic tumour should now be classified as an low grade carcinoma and adequate treatment has to be initiated. The patient, a 9-year-old girl, had undergone a suprahyoid access for total tumor removal with a bilateral neck exploration. Postsurgical radiotherapy has to be done in case with perineural invasion, invaded margins, node invasion or high grade tumor. The clinical and histopathological findings are discussed in the light of the literature.

Resume Le syndrome de Kikuchi-Fujimoto est une lymphadenite histiocytaire necrosante qui s'observe a tous les âges, mais preferentiellement chez l'adulte jeune. Le sex-ratio est de 4: 1 en faveur de la femme. Il se traduit cliniquement par des adenopathies principalement cervicales dans un contexte febrile et d'asthenie. Il existe parfois une leucopenie transitoire et un syndrome inflammatoire modere. L'evolution est favorable spontanement en 1 a 3 mois mais des rechutes sont possibles. L'histologie ganglionnaire peut etre confondue avec celle d'un lymphome malin d'ou l'interet des immunomarquages (anticorps anti-Ki-MIP ou KP1). L'etiologie est inconnue mais une origine infectieuse a ete suspectee (toxoplasmose, virus d'Epstein-Barr). Son association avec un lupus a deja ete decrite, faisant ainsi discuter la physiopathologie de ce syndrome. Nous rapportons deux nouveaux cas de syndrome de Kikuchi dont un est probablement secondaire a une primo-infection a EBV et l'autre associe a un lupus.

ANCA; immune complex-mediated glom- At admission, she presented with bilateral pretibialerulonephritis; infectious diseases; shunt nephritis oedema and a pattern of anaemia. Her temperaturewas normal. Blood pressure was 150/80 mmHg.Clinical examination showed no neurologic, cardiac,pulmonary or cutaneous abnormalities. Laboratory

A significant number of patients with small renal tumours may get benefit from in situ thermo‐ablation techniques. Focused ultrasound is a non‐invasive approach which offers excellent flexibility. On the other hand, real time MR thermometry is a valuable tool for monitoring and controlling therapy. In this study, coupling of focused ultrasound with PRF‐based, respiratory‐gated MR thermometry was used to provide temperature feedback control for local hyperthermia in the rabbit kidney. Two heating protocols were initially used in healthy kidneys (medulla and cortex): 1. fixed focal point heating; 2. spiral trajectories of the focal point. Further, five VX2 renal carcinomas were treated with multiple focal point heating in each tumour. Post‐treatment MRI follow up and post mortem histology were performed. The shape and size of the lesions (MRI, histology) were compared to the calculated thermal dose map. The standard deviation of the MR thermometry ranged from 0.5°C to 1°C. The temperature controller matched the objective curve with approximately 1°C precision (fixed focal point mode). Several technical and physiological difficulties for spiral heating could not be overcome with the available setup. Thermal ablation with temperature feedback control in healthy and tumour bearing kidney was demonstrated to be feasible and effective, despite specific challenges (deep seated organ, respiratory motion, high blood perfusion).

We report on a cryoglobulinemia revealed in a 73 year old woman by lower limb ischemia, livedo reticularis and end stage renal disease simulating cholesterol embol disease. The diagnosis was made on post-mortem features.

Essential mixed cryoglobulinemia, which can cause hypersensitivity vasculitis, was observed in five patients with peripheral neuropathy. Three cases presented with multifocal neuropathies and two cases with symmetrical polyneuropathy. One had cryoglobulinemia with IgM monoclonal gammopathy and IgG polyclonal gammopathy, and the other four had cryoglobulinemia with polyclonal gammopathy. Biopsies showed perivascular infiltration by mononuclaer cells around medium, and mainly small-sized blood vessels. This was observed in the epineurium (five cases) and muscular fragments (three cases). At ultrastructural examination two cases showed severe damage of most myelinated fibers, which presented acute stages of Wallerian-like degeneration, and the three other cases showed a less widespread destruction of myelinated fibers. Most endoneurial capillaries showed swollen endoneurial cells. Myelino-axonal degeneration of myelinated fibers is probably due mainly to the vasculitis always present in the epineurium. This damage was probably worsened by the modifications of endoneurial capillaries. These lesions and their mechanisms are quite different from those observed in cases of cryoglobulinemia with an isolated monoclonal gammopathy.

Seven years after a cadaver kidney transplantation a 33-year-old man presented with a monoclonal gammopathy secondarily complicated by AL amyloidosis mainly expressed as a sicca syndrome, gammopathy that ultimately developed into multiple myeloma. The mechanisms responsible for the occurrence of monoclonal gammopathy in renal transplant recipients are discussed.

International audience; Surgery and antifungals are the reference standard for rhino-orbito-cerebral mucormycosis (ROCM) treatment. The impact of local control on survival of 22 consecutive ROCM adults was studied on day 90: none vs. 75% died, respectively, with or without local control (p